Outcome of the Traumatic Extradural Hematoma on the Basis of Size of Extradural Hematoma
DOI:
https://doi.org/10.36552/pjns.v25i2.524Abstract
Objective: This study aimed to determine the outcome of traumatic extradural hematoma and to compare the outcome of small and large size extradural hematoma.Materials & Methods: A descriptive case series was carried out in the Department of Neurosurgery, Hayatabad Medical Complex Peshawar for six months and included 188 patients. The detailed history and clinical examinations were noted through a pre-designed proforma. Patients were followed post-operatively till the time of discharge and for either favorable outcome or unfavorable outcome according to the GOS.
Results: 73% of patients had extradural hematoma volume between 25 – 50 mL, while 27% patients had extradural hematoma >50 mL. 12% of patients had Glasgow Outcome Score (GOS) scores 1 – 3, while 88% of patients had GOS scores: 4 – 5. The mean GOS was 3. Patients with favorable outcomes were 88% while 12% had an unfavorable outcome.
Conclusion: The size of the extradural hematoma has a strong correlation with outcome. The greater the size of the hematoma, the poorer the outcome.
References
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3. Cheung PS, Lam JM, Yeung JH, Graham CA, Rainer TH. Outcome of traumatic extradural haematoma in Hong Kong. Injury, 2007; 38 (1): 76-80.
4. Sun DQ, Andresen NS, Gantz BJ. Surgical management of acute facial palsy. Otolaryngologic Clinics of North America, 2018; 51 (6): 1077-92.
5. ur Rehman R, Mushtaq MIUH, Azam F, Khattak A. Skull fracture on x-ray skull as an indicator of extradural hematoma in patients with head injury. Pak J Surg. 2012; 28 (2): 106-9.
6. Gerlach R, Dittrich S, Schneider W, Ackermann H, Seifert V, Kieslich M. Traumatic epidural hematomas in children and adolescents: outcome analysis in 39 consecutive unselected cases. Pediatric Emergency Care, 2009; 25 (3): 164-9.
7. Ringl H, Schernthaner R, Philipp MO, Metz-Schimmerl S, Czerny C, Weber M, et al. Three-dimensional fracture visualisation of multidetector CT of the skull base in trauma patients: comparison of three reconstruction algorithms. European Radiology, 2009; 19 (10): 2416-24.
8. Mishra SS, Nanda N, Deo RC. Extradural hematoma in an infant of 8 months. Journal of Pediatric Neurosciences, 2011; 6 (2): 158.
9. Saatman KE, Duhaime A-C, Bullock R, Maas AI, Valadka A, Manley GT. Classification of traumatic brain injury for targeted therapies. Journal of Neurotrauma, 2008; 25 (7): 719-38.
10. Pereira CU, Santos LPA. “Sinal do redemoinho” em hematoma extradural hiperagudo. 2013.
11. McGinn MJ, Povlishock JT. Pathophysiology of traumatic brain injury. Neurosurgery Clinics, 2016; 27 (4): 397-407.
12. Juratli TA, Zang B, Litz RJ, Sitoci K-H, Aschenbrenner U, Gottschlich B, et al. Early hemorrhagic progression of traumatic brain contusions: frequency, correlation with coagulation disorders, and patient outcome: a prospective study. Journal of Neurotrauma, 2014; 31 (17):
1521-7.
13. Kinoshita K. Traumatic brain injury: pathophysiology for neurocritical care. Journal of Intensive Care, 2016; 4 (1): 29.
14. Pearn ML, Niesman IR, Egawa J, Sawada A, Almenar-Queralt A, Shah SB, et al. Pathophysiology associated with traumatic brain injury: current treatments and potential novel therapeutics. Cellular and Molecular Neurobiology, 2017; 37 (4): 571-85.
15. Li M, Zhao Z, Yu G, Zhang J. Epidemiology of traumatic brain injury over the world: a systematic review. General medicine: open Access, 2016; 4 (5): e275-e.
16. Peeters W, van den Brande R, Polinder S, Brazinova A, Steyerberg EW, Lingsma HF, et al. Epidemiology of traumatic brain injury in Europe. Acta Neurochirurgica. 2015; 157 (10): 1683-96.
17. Tagliaferri F, Compagnone C, Korsic M, Servadei F, Kraus J. A systematic review of brain injury epidemiology in Europe. Acta Neurochirurgica. 2006; 148 (3): 255-68.
18. Chrousos GA, Cogan DG. Absence of the near reflex in a healthy adolescent. Journal of Pediatric Ophthalmology and Strabismus, 1985; 22 (2): 76-7.
19. Haque ME, Sultana S, Alam MS, Saha K, Begum W. Socio-demographic Characteristics of Extradural Haematoma (EDH) Patients: Expeience of 63 Cases in Bangladesh. Journal of Science Foundation, 2017; 15 (2): 52-6.
20. Rincon S, Gupta R, Ptak T. Imaging of head trauma. Handbook of clinical neurology. 135: Elsevier, 2016: p. 447-77.
21. Marcus EM, Jacobson S. Cerebral Hemispheres: Neuropathology and Clinical Correlation II. Non-Vascular Syndromes. Integrated Neuroscience: Springer; 2003: p. 597-630.
22. SKULL IT. Regional Injuries. Forensic Medicine and Toxicology.
23. Mauritz W, Brazinova A, Majdan M, Rehorcikova V, Leitgeb J. Deaths due to traumatic brain injury in Austria between 1980 and 2012. Brain Injury, 2014; 28 (8): 1096-101.
24. Sheth K, McCullough M. The Pathophysiology of Intracranial Hypertension and Cerebral Herniation Syndromes. Cerebral Herniation Syndromes and Intracranial Hypertension, 2016: 1.
25. Elgamal EA. Traumatic Brain Injury and Disorders of Intracranial Pressure in Children. Clinical Child Neurology: Springer, 2020: p. 1001-31.
26. Pearl GS. Traumatic neuropathology. Clinics in Laboratory Medicine, 1998; 18 (1): 39-64.
27. McCarthy DP, Donald PF, Scharlemann JP, Buchanan GM, Balmford A, Green JM, et al. Financial costs of meeting global biodiversity conservation targets: current spending and unmet needs. Science, 2012; 338 (6109): 946-9.
28. Mckissock W, Richardson A, Taylor J. Primary intracerebral haemorrhage: a controlled trial of surgical and conservative treatment in 180 unselected cases. The Lancet, 1961; 278 (7196): 221-6.
29. Postuma RB, Berg D, Stern M, Poewe W, Olanow CW, Oertel W, et al. MDS clinical diagnostic criteria for Parkinson's disease. Movement Disorders, 2015; 30 (12): 1591-601.
30. Bullock MR, Chesnut R, Ghajar J, Gordon D, Hartl R, Newell DW, et al. Surgical management of acute subdural hematomas. Neurosurgery, 2006; 58 (suppl_3): S2-16-S2-24.
31. Teasdale G, Jennett B. Assessment of coma and impaired consciousness: a practical scale. The Lancet, 1974; 304 (7872): 81-4.
32. Aurangzeb A, Afridi EA, Khan SA, Muhammad G, Ihsan A, Hussain I, Zadran KK, Bhatti SN. Frequency of extradural haematoma in patients with linear skull fracture. Journal of Ayub Medical College Abbottabad, 2015; 27 (2): 314-7.
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2021-06-14
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